Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects

Joel Korkala; Sanjeet Avtaar Singh; Sudeep Das De; Alan Kirk

doi:doi:10.11648/j.ccr.20170102.14

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Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects

Joel Korkala, Sanjeet Avtaar Singh, Sudeep Das De, Alan Kirk

Published in Cardiology and Cardiovascular Research (Volume 1, Issue 2)

Received: 26 February 2017 Accepted: 28 March 2017 Published: 17 April 2017

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Abstract

Approximately 100 cardiac transplants are performed yearly in the UK. The choice of maintenance immunosuppression regimes, however, varies due to the dearth of evidence. Tacrolimus and ciclosporin are used most commonly. An added benefit of tacrolimus has been suggested due to reduced rejection rates and side effect profile, particularly nephrotoxicity. The results were reviewed at the Scottish National Advanced Heart Failure Service. A retrospective analysis of data from 50 patients was conducted. All patients had undergone orthotopic heart transplantation between September 2010 and June 2016. In addition to tacrolimus or ciclosporin all patients also received mycophenolate mofetil and corticosteroids. Serum creatinine levels and estimated glomerular filtration rates (eGFR) were compared at 3 monthly intervals during follow-up post-transplant. Statistical analysis was performed using Student’s t-test for continuous variables and Chi-squared test for categorical variables. The drug regimens remained unchanged in all patients through the study period. The eGFR was significantly higher in the ciclosporin group compared to the tacrolimus group at 9 months (p=0.045) and 1 year (p=0.025). There was also a trend towards higher serum creatinine in the tacrolimus group (p=0.125 at 12 months). This study indicates there is a significant impairment of renal function in patients on tacrolimus compared to ciclosporin. Larger studies and longer follow-up is needed to denote if this impairment is sustained and irreversible.

Published in	Cardiology and Cardiovascular Research (Volume 1, Issue 2)
DOI	10.11648/j.ccr.20170102.14
Page(s)	48-56
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Cardiac Transplantation, Immunosuppression, Tacrolimus, Ciclosporin, Renal Function

References

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APA Style

Joel Korkala, Sanjeet Avtaar Singh, Sudeep Das De, Alan Kirk. (2017). Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects. Cardiology and Cardiovascular Research, 1(2), 48-56. https://doi.org/10.11648/j.ccr.20170102.14

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ACS Style

Joel Korkala; Sanjeet Avtaar Singh; Sudeep Das De; Alan Kirk. Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects. Cardiol. Cardiovasc. Res. 2017, 1(2), 48-56. doi: 10.11648/j.ccr.20170102.14

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AMA Style

Joel Korkala, Sanjeet Avtaar Singh, Sudeep Das De, Alan Kirk. Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects. Cardiol Cardiovasc Res. 2017;1(2):48-56. doi: 10.11648/j.ccr.20170102.14

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@article{10.11648/j.ccr.20170102.14,
  author = {Joel Korkala and Sanjeet Avtaar Singh and Sudeep Das De and Alan Kirk},
  title = {Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects},
  journal = {Cardiology and Cardiovascular Research},
  volume = {1},
  number = {2},
  pages = {48-56},
  doi = {10.11648/j.ccr.20170102.14},
  url = {https://doi.org/10.11648/j.ccr.20170102.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20170102.14},
  abstract = {Approximately 100 cardiac transplants are performed yearly in the UK. The choice of maintenance immunosuppression regimes, however, varies due to the dearth of evidence. Tacrolimus and ciclosporin are used most commonly. An added benefit of tacrolimus has been suggested due to reduced rejection rates and side effect profile, particularly nephrotoxicity. The results were reviewed at the Scottish National Advanced Heart Failure Service. A retrospective analysis of data from 50 patients was conducted. All patients had undergone orthotopic heart transplantation between September 2010 and June 2016. In addition to tacrolimus or ciclosporin all patients also received mycophenolate mofetil and corticosteroids. Serum creatinine levels and estimated glomerular filtration rates (eGFR) were compared at 3 monthly intervals during follow-up post-transplant. Statistical analysis was performed using Student’s t-test for continuous variables and Chi-squared test for categorical variables. The drug regimens remained unchanged in all patients through the study period. The eGFR was significantly higher in the ciclosporin group compared to the tacrolimus group at 9 months (p=0.045) and 1 year (p=0.025). There was also a trend towards higher serum creatinine in the tacrolimus group (p=0.125 at 12 months). This study indicates there is a significant impairment of renal function in patients on tacrolimus compared to ciclosporin. Larger studies and longer follow-up is needed to denote if this impairment is sustained and irreversible.},
 year = {2017}
}

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TY - JOUR
T1 - Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects
AU - Joel Korkala
AU - Sanjeet Avtaar Singh
AU - Sudeep Das De
AU - Alan Kirk
Y1 - 2017/04/17
PY - 2017
N1 - https://doi.org/10.11648/j.ccr.20170102.14
DO - 10.11648/j.ccr.20170102.14
T2 - Cardiology and Cardiovascular Research
JF - Cardiology and Cardiovascular Research
JO - Cardiology and Cardiovascular Research
SP - 48
EP - 56
PB - Science Publishing Group
SN - 2578-8914
UR - https://doi.org/10.11648/j.ccr.20170102.14
AB - Approximately 100 cardiac transplants are performed yearly in the UK. The choice of maintenance immunosuppression regimes, however, varies due to the dearth of evidence. Tacrolimus and ciclosporin are used most commonly. An added benefit of tacrolimus has been suggested due to reduced rejection rates and side effect profile, particularly nephrotoxicity. The results were reviewed at the Scottish National Advanced Heart Failure Service. A retrospective analysis of data from 50 patients was conducted. All patients had undergone orthotopic heart transplantation between September 2010 and June 2016. In addition to tacrolimus or ciclosporin all patients also received mycophenolate mofetil and corticosteroids. Serum creatinine levels and estimated glomerular filtration rates (eGFR) were compared at 3 monthly intervals during follow-up post-transplant. Statistical analysis was performed using Student’s t-test for continuous variables and Chi-squared test for categorical variables. The drug regimens remained unchanged in all patients through the study period. The eGFR was significantly higher in the ciclosporin group compared to the tacrolimus group at 9 months (p=0.045) and 1 year (p=0.025). There was also a trend towards higher serum creatinine in the tacrolimus group (p=0.125 at 12 months). This study indicates there is a significant impairment of renal function in patients on tacrolimus compared to ciclosporin. Larger studies and longer follow-up is needed to denote if this impairment is sustained and irreversible.
VL - 1
IS - 2
ER -

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Author Information

Joel Korkala

School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
Sanjeet Avtaar Singh

Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom
Sudeep Das De

Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom
Alan Kirk

Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom

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Joel Korkala, Sanjeet Avtaar Singh, Sudeep Das De, Alan Kirk. (2017). Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects. Cardiology and Cardiovascular Research, 1(2), 48-56. https://doi.org/10.11648/j.ccr.20170102.14

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ACS Style

Joel Korkala; Sanjeet Avtaar Singh; Sudeep Das De; Alan Kirk. Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects. Cardiol. Cardiovasc. Res. 2017, 1(2), 48-56. doi: 10.11648/j.ccr.20170102.14

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AMA Style

Joel Korkala, Sanjeet Avtaar Singh, Sudeep Das De, Alan Kirk. Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects. Cardiol Cardiovasc Res. 2017;1(2):48-56. doi: 10.11648/j.ccr.20170102.14

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@article{10.11648/j.ccr.20170102.14,
  author = {Joel Korkala and Sanjeet Avtaar Singh and Sudeep Das De and Alan Kirk},
  title = {Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects},
  journal = {Cardiology and Cardiovascular Research},
  volume = {1},
  number = {2},
  pages = {48-56},
  doi = {10.11648/j.ccr.20170102.14},
  url = {https://doi.org/10.11648/j.ccr.20170102.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20170102.14},
  abstract = {Approximately 100 cardiac transplants are performed yearly in the UK. The choice of maintenance immunosuppression regimes, however, varies due to the dearth of evidence. Tacrolimus and ciclosporin are used most commonly. An added benefit of tacrolimus has been suggested due to reduced rejection rates and side effect profile, particularly nephrotoxicity. The results were reviewed at the Scottish National Advanced Heart Failure Service. A retrospective analysis of data from 50 patients was conducted. All patients had undergone orthotopic heart transplantation between September 2010 and June 2016. In addition to tacrolimus or ciclosporin all patients also received mycophenolate mofetil and corticosteroids. Serum creatinine levels and estimated glomerular filtration rates (eGFR) were compared at 3 monthly intervals during follow-up post-transplant. Statistical analysis was performed using Student’s t-test for continuous variables and Chi-squared test for categorical variables. The drug regimens remained unchanged in all patients through the study period. The eGFR was significantly higher in the ciclosporin group compared to the tacrolimus group at 9 months (p=0.045) and 1 year (p=0.025). There was also a trend towards higher serum creatinine in the tacrolimus group (p=0.125 at 12 months). This study indicates there is a significant impairment of renal function in patients on tacrolimus compared to ciclosporin. Larger studies and longer follow-up is needed to denote if this impairment is sustained and irreversible.},
 year = {2017}
}

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